母亲孕前BMI和孕期增重对学龄前儿童超重肥胖的影响(新)
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Organization (WHO) reference were considered as overweight, and >95th percentiles for age and genders cut-off values were considered as obesity (pathological and secondary causes of obesity were excluded).
childhood overweight and adiposity. Results Of the 3 797 pregnant women, the prevalence of underweight, normal weight, overweight and obesity were respectively 22.6% (n=858), 70.3% (n=2 671), 6.2% (n=234) and 0.9% (n=34). There were 3 563 pregnant women who were obtained gestational weight gain data, the prevalence of inadequate GWG, appropriate GWG, excessive GWG were respectively 12.4% (n=443), 25.9% (n=922) and 61.7% (n=2 198). The prevalence of overweight and obesity were 11.5% (n=437) and 10.8% (n=
【关键词】 儿童，学龄前； 怀孕期间； 超重； 肥胖症; 队列研究 基金项目：国家自然科学基金（81573168）
Maternal pre-pregnancy body mass index and gestational weight gain with preschool children's overweight and obesity Shao Ting*, Tao Huihui, Ni Lingling, Sun Yanli , Yan Shuangqin, Gu Chunli, Cao Hui, Huang Kun, Hao Jiahu，Tao Fangbiao. *Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University；Anhui Provincial Laboratory of Population Health and Eugenics, Hefei 230032, China
DOI：10.3760/cma.j.issn.0253-9624.2016.02.005 作者单位：230032 合肥，安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 安徽人口健康与优生省级实 验室（邵婷、陶慧慧、倪玲玲、孙艳丽、黄锟、郝加虎、陶芳标）；马鞍山市妇幼保健院（严双琴、顾春丽、曹慧） 通信作者: 郝加虎，Email：jia7128@126.com
Gestational weight gain was defined according to the Institute of Medicine (IOM) guidelines. Univariate and binary regression model analysis was used to examine the effect of pre-pregnancy BMI and GWG with
· 124 ·
中华预防医学杂志 2016 年 2 月第 50 卷第 2 期 Chin J Prev Med，February 2016, Vol. 50, No. 2
children were followed up. Children whose BMI were >85th percentiles for age and genders of World Health
their children. 【Key words】 Child, preschool; Peripartum period; Overweight; Obesity; Cohort studies Fund Program: National Natural Science Foundation of China (81573168)
Corresponding author: Hao Jiahu, Email: jia7128@126.com
【Abstract】 Objective To examine the effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity, and to explore possible early life risk factors for obesity in preschool children. Methods Basic information of pregnant women and gestation period came from the Ma'anshan Birth Cohort Study，a part of the China-Anhui Birth Cohort Study (C-ABCS) . Pregnant women in routine health care from four municipal medical and health institutions were enrolled voluntarily during October 2008 and October 2010 in Ma'anshan City. A total of 5 084 pregnant women and 4 669 singleton live births were included in this study. Between April 2014 and April 2015, 3 797
【摘要】 目的 分析母亲孕前 BMI 和孕期增重与学龄前儿童超重肥胖的关联，探讨学龄前儿童 发生超重肥胖的生命早期影响因素。方法 孕妇和孕期基本信息来源于中国安徽出生队列 （C-ABCS）中的马鞍山市出生队列，该队列于 2008 年 10 月至 2010 年 10 月在马鞍山市 4 家市级医疗卫 生机构接受孕期保健的孕妇中招募研究对象，共计 5 084 名孕妇及 4 669 名单胎活产儿进入队列。于 2014 年 4 月至 2015 年 4 月对该队列进行随访，最终 3 797 名儿童纳入本次分析。相应性别及月龄儿童 BMI 高于 WHO 标准中 BMI 第 85 百分位数界定为超重，高于第 95 百分位数界定为肥胖（排除病理性及 继发性肥胖者）；参考 2009 年美国医学研究所(IOM)新修订的孕期增重推荐值判定母亲孕期增重情 况。运用多因素二分类非条件 logistic 回归模型分析母亲孕前 BMI 和孕期增重与学龄前儿童超重肥 胖的关系。结果 随访到的 3 797 名母亲中，孕前低体重、正常，超重和肥胖者分别占 22.6%（858 名）、 70.3%（2 671 名）、6.2%（234 名）和 0.9%（34 名）。有孕期增重数据的 3 563 名母亲中，孕期增重不足、适 宜和过度者分别占 12.4%（443 名）、25.9%（922 名）和 61.7%（2 198 名）。学龄前儿童超重率为 11.5% （437 名），肥胖率为 10.8%（411 名）。控制分娩孕周、儿童性别、月龄、出生体重、6 月龄母乳喂养和目 前家庭月收入混杂因素后，母亲孕前超重肥胖（OR=2.01，95%CI：1.53～2.65）和孕期增重过度（OR= 1.65，95%CI：1.35～2.03）是学龄前儿童超重肥胖的危险因素；孕前低体重是保护因素（OR=0.49，95% CI：0.39～0.62）。母亲孕前较高的 BMI 和孕期增重不适宜对儿童超重肥胖存在联合作用：与仅母亲孕 前超重肥胖、孕期增重过度或孕期增重不足的单独作用相比，母亲孕前超重肥胖合并孕期增重过度或 母亲孕前超重肥胖合并孕期增重不足，子代发生超重肥胖的风险更高，OR（95%CI）值分别为 2.90 （1.97～4.28）、3.17（1.44～6.97）。结论 母亲孕前较高的 BMI 和不适宜的孕期增重是导致学龄前儿 童超重肥胖的危险因素；孕妇应采取科学的方法调整孕前 BMI，并根据孕前 BMI 控制孕期增重，以在 生命早期预防学龄前儿童超重肥胖的发生。
411) in preschool children, respectively. After adjusting confounding factors including age at delivery,
genders of children, children age, birth weight, breastfeeding and household economic status, binary logistic regression analysis showed that pre-pregnancy overweight and obesity(OR=2.01, 95% CI: 1.53- 2.65), excessive GWG(OR=1.65, 95% CI: 1.35- 2.03) were risk factors for overweight and obesity, and pre-pregnancy underweight was protective factor for childhood overweight and obesity (OR=0.49, 95% CI: 0.39-0.62). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study: compared to only pre-pregnancy higher BMI or excessive GWG or indequate GWG, combination of high pre-pregnancy BMI and excessive GWG or high pre-pregnancy BMI and inadequate GWG, adverse effects on childhood overweight and obesity were much higher, OR (95%CI) values were 2.90(1.97-4.28), 3.17(1.446.97) respectively. Conclusion Both high pre-pregnancy BMI and inappropriate GWG are associated with greater offspring BMI. Pregnant women should achieve appropriate weight gain and help prevent obesity in
中华预防医学杂志 2016 年 2 月第 50 卷第 2 期 Chin J Prev Med，February 2016, Vol. 50, No. 2
· 123 ·
wk.baidu.com
·健康与疾病的发育起源·
母亲孕前 BMI 和孕期增重对学龄前儿童 超重肥胖的影响
邵婷 陶慧慧 倪玲玲 孙艳丽 严双琴 顾春丽 曹慧 黄锟 郝加虎 陶芳标
childhood overweight and adiposity. Results Of the 3 797 pregnant women, the prevalence of underweight, normal weight, overweight and obesity were respectively 22.6% (n=858), 70.3% (n=2 671), 6.2% (n=234) and 0.9% (n=34). There were 3 563 pregnant women who were obtained gestational weight gain data, the prevalence of inadequate GWG, appropriate GWG, excessive GWG were respectively 12.4% (n=443), 25.9% (n=922) and 61.7% (n=2 198). The prevalence of overweight and obesity were 11.5% (n=437) and 10.8% (n=
【关键词】 儿童，学龄前； 怀孕期间； 超重； 肥胖症; 队列研究 基金项目：国家自然科学基金（81573168）
Maternal pre-pregnancy body mass index and gestational weight gain with preschool children's overweight and obesity Shao Ting*, Tao Huihui, Ni Lingling, Sun Yanli , Yan Shuangqin, Gu Chunli, Cao Hui, Huang Kun, Hao Jiahu，Tao Fangbiao. *Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University；Anhui Provincial Laboratory of Population Health and Eugenics, Hefei 230032, China
DOI：10.3760/cma.j.issn.0253-9624.2016.02.005 作者单位：230032 合肥，安徽医科大学公共卫生学院儿少卫生与妇幼保健学系 安徽人口健康与优生省级实 验室（邵婷、陶慧慧、倪玲玲、孙艳丽、黄锟、郝加虎、陶芳标）；马鞍山市妇幼保健院（严双琴、顾春丽、曹慧） 通信作者: 郝加虎，Email：jia7128@126.com
Gestational weight gain was defined according to the Institute of Medicine (IOM) guidelines. Univariate and binary regression model analysis was used to examine the effect of pre-pregnancy BMI and GWG with
· 124 ·
中华预防医学杂志 2016 年 2 月第 50 卷第 2 期 Chin J Prev Med，February 2016, Vol. 50, No. 2
children were followed up. Children whose BMI were >85th percentiles for age and genders of World Health
their children. 【Key words】 Child, preschool; Peripartum period; Overweight; Obesity; Cohort studies Fund Program: National Natural Science Foundation of China (81573168)
Corresponding author: Hao Jiahu, Email: jia7128@126.com
【Abstract】 Objective To examine the effect of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) with childhood overweight and adiposity, and to explore possible early life risk factors for obesity in preschool children. Methods Basic information of pregnant women and gestation period came from the Ma'anshan Birth Cohort Study，a part of the China-Anhui Birth Cohort Study (C-ABCS) . Pregnant women in routine health care from four municipal medical and health institutions were enrolled voluntarily during October 2008 and October 2010 in Ma'anshan City. A total of 5 084 pregnant women and 4 669 singleton live births were included in this study. Between April 2014 and April 2015, 3 797
【摘要】 目的 分析母亲孕前 BMI 和孕期增重与学龄前儿童超重肥胖的关联，探讨学龄前儿童 发生超重肥胖的生命早期影响因素。方法 孕妇和孕期基本信息来源于中国安徽出生队列 （C-ABCS）中的马鞍山市出生队列，该队列于 2008 年 10 月至 2010 年 10 月在马鞍山市 4 家市级医疗卫 生机构接受孕期保健的孕妇中招募研究对象，共计 5 084 名孕妇及 4 669 名单胎活产儿进入队列。于 2014 年 4 月至 2015 年 4 月对该队列进行随访，最终 3 797 名儿童纳入本次分析。相应性别及月龄儿童 BMI 高于 WHO 标准中 BMI 第 85 百分位数界定为超重，高于第 95 百分位数界定为肥胖（排除病理性及 继发性肥胖者）；参考 2009 年美国医学研究所(IOM)新修订的孕期增重推荐值判定母亲孕期增重情 况。运用多因素二分类非条件 logistic 回归模型分析母亲孕前 BMI 和孕期增重与学龄前儿童超重肥 胖的关系。结果 随访到的 3 797 名母亲中，孕前低体重、正常，超重和肥胖者分别占 22.6%（858 名）、 70.3%（2 671 名）、6.2%（234 名）和 0.9%（34 名）。有孕期增重数据的 3 563 名母亲中，孕期增重不足、适 宜和过度者分别占 12.4%（443 名）、25.9%（922 名）和 61.7%（2 198 名）。学龄前儿童超重率为 11.5% （437 名），肥胖率为 10.8%（411 名）。控制分娩孕周、儿童性别、月龄、出生体重、6 月龄母乳喂养和目 前家庭月收入混杂因素后，母亲孕前超重肥胖（OR=2.01，95%CI：1.53～2.65）和孕期增重过度（OR= 1.65，95%CI：1.35～2.03）是学龄前儿童超重肥胖的危险因素；孕前低体重是保护因素（OR=0.49，95% CI：0.39～0.62）。母亲孕前较高的 BMI 和孕期增重不适宜对儿童超重肥胖存在联合作用：与仅母亲孕 前超重肥胖、孕期增重过度或孕期增重不足的单独作用相比，母亲孕前超重肥胖合并孕期增重过度或 母亲孕前超重肥胖合并孕期增重不足，子代发生超重肥胖的风险更高，OR（95%CI）值分别为 2.90 （1.97～4.28）、3.17（1.44～6.97）。结论 母亲孕前较高的 BMI 和不适宜的孕期增重是导致学龄前儿 童超重肥胖的危险因素；孕妇应采取科学的方法调整孕前 BMI，并根据孕前 BMI 控制孕期增重，以在 生命早期预防学龄前儿童超重肥胖的发生。
411) in preschool children, respectively. After adjusting confounding factors including age at delivery,
genders of children, children age, birth weight, breastfeeding and household economic status, binary logistic regression analysis showed that pre-pregnancy overweight and obesity(OR=2.01, 95% CI: 1.53- 2.65), excessive GWG(OR=1.65, 95% CI: 1.35- 2.03) were risk factors for overweight and obesity, and pre-pregnancy underweight was protective factor for childhood overweight and obesity (OR=0.49, 95% CI: 0.39-0.62). Joint associations of pre-pregnancy BMI and inappropriate GWG were also noticed in the study: compared to only pre-pregnancy higher BMI or excessive GWG or indequate GWG, combination of high pre-pregnancy BMI and excessive GWG or high pre-pregnancy BMI and inadequate GWG, adverse effects on childhood overweight and obesity were much higher, OR (95%CI) values were 2.90(1.97-4.28), 3.17(1.446.97) respectively. Conclusion Both high pre-pregnancy BMI and inappropriate GWG are associated with greater offspring BMI. Pregnant women should achieve appropriate weight gain and help prevent obesity in
中华预防医学杂志 2016 年 2 月第 50 卷第 2 期 Chin J Prev Med，February 2016, Vol. 50, No. 2
· 123 ·
wk.baidu.com
·健康与疾病的发育起源·
母亲孕前 BMI 和孕期增重对学龄前儿童 超重肥胖的影响
邵婷 陶慧慧 倪玲玲 孙艳丽 严双琴 顾春丽 曹慧 黄锟 郝加虎 陶芳标